Huang Tzu-Yen, Wang Shih-Wei, Tseng Hsin-Yi, Randolph Gregory W, Dionigi Gianlorenzo, Lin Yi-Chu, Chuang Cheng-Hsun, Lu I-Cheng, Lin Chih-Hung, Chan Leong-Perng, Chiang Feng-Yu, Wu Che-Wei
Department of Otorhinolaryngology-Head and Neck Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
Department of Otorhinolaryngology, School of Post-Baccalaureate Medicine and School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Otolaryngol Head Neck Surg. 2025 Jan;172(1):63-73. doi: 10.1002/ohn.1017. Epub 2024 Oct 15.
When performing radiofrequency ablation for thyroid nodules, it is essential to avoid thermal injury to the recurrent laryngeal nerve. This porcine animal model study used continuous intraoperative neuromonitoring to investigate the thermal safety parameters of thyroid radiofrequency ablation.
Porcine animal study.
University animal laboratory.
Twelve piglets were tested at different radiofrequency power levels, and the real-time electromyography signal changes were recorded under continuous intraoperative neuromonitoring. The spread heat study (8 piglets) included spontaneous recovery tests and cold water irrigation tests to investigate the safety distance from the recurrent laryngeal nerve to the active tip during 5-second activation with standard stimulation patterns. The residual heat study (4 piglets) investigated the safety cooling durations by touching the recurrent laryngeal nerve with the tip after a 5-second activation.
In the spread heat study, substantial signal attenuation events were observed at an spread heat distance of 2, 3, 5, and 5 mm when the power was set as 10, 20, 30, and 50 W, respectively. No signal recovery could be observed in 20 minutes with or without cold water irrigation in the injured recurrent laryngeal nerve area. The residual heat study shows the residual thermal effect of the tip is minimal, and no substantial signal attenuation event was observed at all experiments.
This innovative study established the thermal safety parameters for radiofrequency ablation in a porcine model at various power levels, which can potentially assist operators in delineating a precise ablation field and providing effective thyroid ablation treatment safely.
在对甲状腺结节进行射频消融时，避免对喉返神经造成热损伤至关重要。本猪动物模型研究采用术中连续神经监测来探究甲状腺射频消融的热安全参数。
猪动物研究。
大学动物实验室。
对12只仔猪在不同射频功率水平下进行测试，并在术中连续神经监测下记录实时肌电图信号变化。热扩散研究（8只仔猪）包括自发恢复测试和冷水冲洗测试，以研究在标准刺激模式下激活5秒期间，喉返神经与活性电极尖端之间的安全距离。余热研究（4只仔猪）通过在激活5秒后用电极尖端触碰喉返神经来研究安全冷却持续时间。
在热扩散研究中，当功率分别设置为10、20、30和50瓦时，在热扩散距离为2、3、5和5毫米处观察到明显的信号衰减事件。在受伤的喉返神经区域，无论有无冷水冲洗，20分钟内均未观察到信号恢复。余热研究表明电极尖端的余热效应极小，在所有实验中均未观察到明显的信号衰减事件。
这项创新性研究在猪模型中确定了不同功率水平下射频消融的热安全参数，这可能有助于操作人员划定精确的消融区域，并安全地提供有效的甲状腺消融治疗。
